HEALING HAVEN MENTAL HEALTH
NPI 1922975978
Social Worker - Clinical in San Jacinto, CA

Active since October 22, 2025
1519 WASHINGTON AVE, SAN JACINTO, CA 92583(650) 559-4850 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Healing Haven Mental Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEALING HAVEN MENTAL HEALTH (NPI 1922975978) is a healthcare organization registered as a clinical in San Jacinto, California and active in the NPI registry since October 2025. The organization lists Kenyada Marie Wagoner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1922975978
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameHEALING HAVEN MENTAL HEALTH
Location Address1519 WASHINGTON AVESan Jacinto, CA 92583-6075
Mailing Address315 E Esplanade Ave Unit 89San Jacinto, CA 92583-5102 · (951) 214-5071
Organization SubpartNo
Authorized OfficialKenyada Marie WagonerCeo · (650) 559-4850
Enumeration DateOctober 22, 2025
Last NPPES UpdateApril 27, 2026
NPPES CertifiedApril 27, 2026
✔ NPI 1922975978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1519 WASHINGTON AVE, San Jacinto, CA 92583

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Healing Haven Mental Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Healing Haven Mental Health, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Social Worker
NPI 1760172688
4361 LATHAM ST STE 220
Riverside, CA 92501
(858) 279-1223
✔ PECOS30 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Healing Haven Mental Health's NPI number?

The NPI number for Healing Haven Mental Health is 1922975978. It was assigned to this organization in the NPPES registry on October 22, 2025.

Where is Healing Haven Mental Health located?

Healing Haven Mental Health is located at 1519 Washington Ave, San Jacinto, CA 92583. The listed phone number is (650) 559-4850.

What is Healing Haven Mental Health's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Healing Haven Mental Health enrolled in Medicare?

Yes. Healing Haven Mental Health is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Healing Haven Mental Health?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Healing Haven Mental Health. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Healing Haven Mental Health was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.